I, the undersigned parent or guardian, hereby consent to my child/children, named below, to participate in Word of Life at Mt. Zion Baptist Church. **The child/children listed below will ONLY be picked up and dropped off at the address listed on this form. Please make plans for the adults listed on this form to be at that location for pick up and drop off of the child.**

I grant my child permission to ride the church bus to and from Mt. Zion, and understand that my child will be expected to abide by all guidelines for safety and conduct required by Mt. Zion. If my child has medical conditions that may be relevant to a physician in the event of an emergency, I have listed them below. In the event an emergency occurs, I may be reached at the telephone number listed below. If I cannot be reached, I hereby authorize the church administration or church official to make emergency medical decisions for my child. If there are any activities I do not want my child to be involved in, I have listed them below.I understand and hereby agree to assume all of the risks which may be encountered on said activity, including activities preliminary and subsequent thereto. I do agree to hold Mt. Zion Baptist Church and its agents and employees, harmless from any and all liability, actions, causes of actions, claims, expenses, and damages on account of injury to my child or property, which I now have or which may arise in the future in connection with the activity or participation in any other associated activities.I expressly agree that this release, waiver, and indemnity agreement is intended to be broad and inclusive as permitted by the law of the State of Georgia and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This release contains the entire agreement between the parties hereto and the terms of this release are contractual and not a mere recital.I further state that I have carefully read the foregoing release and know the contents thereof and I sign this release as my own free act. This is a legally binding agreement that I have read and understand.                       

WARNING:  Under Georgia law, there is no liability for an injury or death of an individual entering these premises if such injury or death results from the inherent risks of contracting COVID-19. You are assuming this risk by entering these premises.